Quaternary ammonium salts as m3 antagonists

ABSTRACT

Compounds of formula (I), in salt or zwitterionic form, wherein J, L, M, R 1 , R 2 , R 3 , R 4  and R 5  have the meanings as indicated in the specification, are useful for treating conditions that are mediated by the muscarinic M3 receptor. Pharmaceutical compositions that contain the compounds and a process for preparing the compounds are also described.

This invention relates to organic compounds, their preparation and useas pharmaceuticals.

In one aspect the invention provides compounds of formula I

in salt or zwitterionic form whereinL and M are (a bond and —CH₂—CH₂—), (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂—and —CH₂—) respectively and J is C₁-C₂-alkylene,or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—)respectively and J is a bond;R¹ is a C₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur;R² is hydrogen, hydroxy, or C₁-C₄-alkyl optionally substituted byhydroxy;R³ is a C₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur,wherein R¹ and R³ are not the same;or —CR¹R²R³ together form a group of formula

where R^(a) is a bond, —O—, —S—, —CH₂—, —CH═CH—, —CH₂—CH₂—, amino or—N(CH₃)—, and R^(b) is hydrogen, hydroxy, or C₁-C₄-alkyl optionallysubstituted by hydroxy;R⁴ is C₁-C₄-alkyl;R⁵ is C₁-alkyl substituted by —SO—R⁶, —S(═O)₂—R⁶, —CO—R⁶, —CO—O—R⁶,—CO—NH—R⁶ or —R⁷, or R⁵ is C₂-C₁₀-alkyl substituted by —O—R⁶, —S—R⁶,—SO—R⁶, —S(═O)₂—R⁶, —CO—R⁶, —O—CO—R⁶, —CO—O—R⁶, —NH—CO—R⁶, —CO—NH—R⁶,—R⁷ or —R⁸,or R⁵ is C₂-C₁₀-alkenyl or C₂-C₁₀-alkynyl optionally substituted by —R⁷or —R⁸;R⁶ is a C₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur,or R⁶ is C₁-C₁₀-alkyl optionally substituted by C₁-C₁₀-alkoxy, —O—R⁷, aC₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclic grouphaving at least one ring heteroatom selected from nitrogen, oxygen andsulphur;R⁷ is a 5- to 12-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur; andR⁸ is a C₃-C₁₅-carbocyclic group; orL and M are (a bond and —CH₂—CH₂—), (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂—and —CH₂—) respectively and J is C₁-C₂-alkylene,or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—)respectively and J is a bond;R¹ and R³ are each independently a C₃-C₁₅-carbocyclic group or a S— to12-membered heterocyclic group having at least one ring heteroatomselected from nitrogen, oxygen and sulphur;R² is hydrogen, hydroxy, or C₁-C₄-alkyl optionally substituted byhydroxy;R⁴ is C₁-C₄-alkyl;R⁵ is C₁-alkyl substituted by —CO—R⁹, —CO—O—R⁹ or —CO—NH—R⁹,or R⁵ is C₂-C₁₀-alkyl substituted by R⁹, —CO—R⁹, —CO—O—R⁹, —NH—CO—R⁹ or—CO—NH—R⁹, andR⁹ is a 5- to 12-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur.

Terms used in the specification have the following meanings:

“Optionally substituted” means the group referred to can be substitutedat one or more positions, preferably one, two or three positions, by anyone or any combination of the radicals described.

“Halo” or “halogen” as used herein denotes an element belonging to group17 (formerly group VII) of the Periodic Table of Elements, which may be,for example, fluorine, chlorine, bromine or iodine.

“C₁-C₁₀-alkyl” as used herein denotes straight chain or branched alkylhaving 1 to 10 carbon atoms.

“C₁-C₂-alkylene” as used herein denotes straight chain or branchedalkylene having 1 or 2 carbon atoms.

“C₂-C₁₀-alkenyl” as used herein denotes straight chain or branchedalkenyl having 2 to 10 carbon atoms.

“C₂-C₁₀-alkynyl” as used herein denotes straight chain or branchedalkynyl having 2 to 10 carbon atoms.

“C₁-C₁₀-alkoxy” as used herein denotes straight chain or branched alkoxyhaving 1 to 10 carbon atoms.

“C₃-C₁₅-carbocyclic group” as used herein denotes a carbocyclic grouphaving 3 to 15 ring carbon atoms, for example a monocyclic group, eithercycloaliphatic, such as a C₃-C₈-cycloalkyl, for example cyclopentyl,cyclohexyl, cycloheptyl or cyclooctyl, or aromatic, such as phenyl,which can be substituted by one or more, usually one or two, C₁-C₄-alkylgroups, or a bicyclic group, such as a C₈-bicyclic, C₉-bicyclic orC₁₀-bicyclic group, which could be cycloaliphatic or could be aromatic,such as indanyl, indenyl or naphthyl, again any of which can besubstituted by one or more, usually one or two, C₁-C₄-alkyl groups. TheC₃-C₁₅-carbocyclic group can be substituted or unsubstituted.

“C₃-C₈-cycloalkyl” as used herein denotes cycloalkyl having 3 to 8carbon atoms.

“C₁-C₁₀-haloalkyl” as used herein denotes C₁-C₁₀-alkyl as hereinbeforedefined substituted by one or more halogen atoms, preferably one, two orthree halogen atoms.

“C₁-C₁₀-alkylcarbonyl” as used herein denotes C₁-C₁₀-alkyl ashereinbefore defined linked to a carbonyl group.

“C₁-C₁₀-alkylsulfonyl” as used herein denotes C₁-C₁₀-alkyl ashereinbefore defined linked to —SO₂—.

“5- to 12-membered heterocyclic group containing at least one ringheteroatom selected from nitrogen, oxygen and sulphur” as used hereindenotes a monoheterocyclic, biheterocyclic or triheterocyclic group,which may be saturated or unsaturated, that has 5 to 12 ring atoms. The5- to 12-membered heterocyclic group can be unsubstituted orsubstituted, e.g. by one, two, three or four substituents.

“Aminocarbonyl” as used herein denotes amino attached through thenitrogen atom to a carbonyl group.

“C₆-C₁₀-aryl” as used herein denotes a monovalent carbocyclic aromaticgroup that contains 6 to 10 carbon atoms and which may be, for example,a monocyclic group such as phenyl or a bicyclic group such as naphthyl.

“C₇-C₁₅-aralkyl” as used herein denotes alkyl, for example C₁-C₅-alkylas hereinbefore defined, substituted by C₆-C₁₀-aryl as hereinbeforedefined.

In compounds of formula I the following are suitable or preferredaspects of the invention either independently or in any combination:

R² is preferably hydroxy. However when R² is C₁-C₄-alkyl, R² ispreferably methyl or ethyl.

R^(b) is preferably hydroxy. However when R^(b) is C₁-C₄-alkyl, R^(b) ispreferably methyl or ethyl.

R⁴ is preferably methyl.

R⁵ is preferably C₁-alkyl substituted by —CO—NH—R⁶, where R⁶ ispreferably a 5- or 6-membered heterocyclic group containing at least onering heteroatom selected from nitrogen, oxygen and sulphur. However whenR⁵ is C₂-C₁₀-alkyl, R⁵ is preferably C₂-C₅-alkyl, especially ethyl,propyl or butyl. When R⁵ is C₂-C₁₀-alkenyl, R⁵ is preferablyC₂-C₄-alkenyl. And when R⁵ is C₂-C₁₀-alkynyl, R⁵ is preferablyC₂-C₈-alkynyl, especially C₂-C₄-alkynyl.

R⁶ is preferably a 5- or 6-membered heterocyclic group containing atleast one ring heteroatom selected from nitrogen, oxygen and sulphur.However when R⁶ is C₁-C₁₀-alkyl, R⁶ is preferably C₁-C₅-alkyl,especially methyl or ethyl, and when R⁶ is C₁-C₁₀-alkyl optionallysubstituted by C₁-C₁₀-alkoxy, R⁶ is preferably C₁-C₅-alkyl substitutedat one, two or three positions by C₁-C₄-alkoxy, especially methoxy orethoxy.

When R¹ or R³ is a C₃-C₁₅-carbocyclic group, R¹ or R³ is preferably aC₃-C₁₀-carbocyclic group, for example C₃-C₈-cycloalkyl, phenyl, indanylor naphthyl, but especially cyclopentyl, cyclohexyl or phenyl.

R¹ and R³ are preferably unsubstituted C₃-C₁₅-carbocyclic groups.However when R¹ or R³ is a C₃-C₁₅-carbocyclic group that is substitutedit is preferably substituted at one, two or three positions by one ormore of halo (especially fluoro), cyano, hydroxy, amino, nitro, carboxy,C₁-C₁₀-alkyl, C₁-C₁₀-haloalkyl, C₁-C₁₀-alkoxy, C₁-C₁₀-alkylcarbonyl,C₁-C₁₀-alkyl-sulfonyl, —SO₂NH₂, —COO—C₆-C₁₀-aryl, —COO—C₇-C₁₅-aralkyl, aC₃-C₁₅-carbocyclic group and a 5- to 12-membered heterocyclic grouphaving at least one ring heteroatom selected from nitrogen, oxygen andsulphur.

When either R⁶ or R⁸ is a C₃-C₁₅-carbocyclic group, it is preferably aC₃-C₁₀-carbocyclic group, for example C₃-C₈-cycloalkyl, phenyl, indanylor naphthyl, but especially phenyl.

R⁶ and R⁸ are preferably unsubstituted C₃-C₁₅-carbocyclic groups.However when either R⁶ or R⁸ is a C₃-C₁₅-carbocyclic group that issubstituted it is preferably substituted at one, two or three positionsby one or more of halo (especially fluoro), cyano, hydroxy, amino,nitro, carboxy, C₁-C₁₀-alkyl, C₁-C₁₀-haloalkyl, C₁-C₁₀-alkoxy,C₁-C₁₀-alkylcarbonyl, C₁-C₁₀-alkyl-sulfonyl, —SO₂NH₂, —COO—C₆-C₁₀-aryl,—COO—C₇-C₁₅-aralkyl, a C₃-C₁₅-carbocyclic group and a 5- to 12-memberedheterocyclic group having at least one ring heteroatom selected fromnitrogen, oxygen and sulphur.

When either R¹, R³, R⁶ or R⁵ is a C₃-C₁₅-carbocyclic group that issubstituted it is preferably substituted at one, two or three positionsby unsubstituted phenyl.

When either R¹, R³, R⁶ or R⁸ is a C₃-C₅-carbocyclic group that issubstituted by halo it is preferably substituted at one, two or threepositions by fluorine, chlorine or bromine.

When either R¹, R³, R⁶ or R⁸ is a C₃-C₁₅-carbocyclic group that issubstituted by C₁-C₁₀-haloalkyl, it is preferably substituted at one,two or three positions by C₁-C₄-haloalkyl.

When either R¹, R³, R⁶ or R⁸ is a C₃-C₁₅-carbocyclic group that issubstituted by C₁-C₁₀-alkylcarbonyl, it is preferably substituted atone, two or three positions by C₁-C₄-alkyl-carbonyl.

When either R¹, R³, R⁶ or R⁸ is a C₃-C₁₅-arbocyclic group that issubstituted by C₁-C₁₀-alkyl-sulfonyl, it is preferably substituted atone, two or three positions by C₁-C₄-alkylsulfonyl.

When either R¹, R³, R⁶ or R⁸ is a C₃-C₁₅-carbocyclic group that issubstituted by —COO—C₆-C₁₀-aryl, it is preferably substituted at one,two or three positions by —COO—C₆-C₈-aryl, especially —COO-phenyl.

When either R¹, R³, R⁶ or R⁸ a C₃-C₁₅-carbocyclic group that issubstituted by —COO—C₇-C₁₅-aralkyl, it is preferably substituted at one,two or three positions by —COO—C₇-C₁₀-aralkyl, especially—COO—C₁-C₄-alkyl-phenyl.

When R¹ or R³ is a 5- to 12-membered heterocyclic group containing atleast one ring heteroatom selected from nitrogen, oxygen and sulphur, R¹or R³ is preferably a 5- to 9-membered heterocyclic group, which can bea monoheterocyclic group such as furyl, pyrrolyl, pyrrolidinyl,pyrazolyl, imidazolyl, triazolyl, tetrazolyl, thienyl, thiadiazolyl,isothiazolyl, oxadiazolyl, pyridinyl, oxazolyl, isoxazolyl, piperidinyl,pyridinyl, pyrazinyl, pyridazinyl, pyrimidinyl, piperazinyl,morpholinyl, triazinyl, oxazinyl or thiazolyl, or a biheterocyclic groupsuch as benzazolyl, benzimidazolyl, indazolyl and benzothiazolyl. WhenR¹ or R³ is a 5- to 9-membered heterocyclic group it is preferablyfuryl, pyrrolyl, triazolyl, thienyl, thiadiazolyl, oxazolyl, isoxazolyl,piperidinyl, pyridinyl, pyrazinyl, benzazolyl, benzimidazolyl, indazolylor benzothiazolyl, but especially thienyl. The 5- to 12-memberedheterocyclic group can be unsubstituted or substituted, e.g. by one,two, three or four substituents selected from halo, cyano, oxo, hydroxy,carboxy, nitro, C₁-C₁₀-alkyl, C₁-C₁₀-alkylcarbonyl and C₁-C₁₀-alkoxyoptionally substituted by aminocarbonyl. However when R¹ or R³ is a 5-to 12-membered heterocyclic group it is especially unsubstitutedthienyl.

When R⁶ or R⁹ is a 5- to 12-membered heterocyclic group containing atleast one ring heteroatom selected from nitrogen, oxygen and sulphur, itis preferably a 5- to 9-membered heterocyclic group, which can be amonoheterocyclic group such as furyl, pyrrolyl, pyrrolidinyl, pyrazolyl,imidazolyl, triazolyl, tetrazolyl, thienyl, thiadiazolyl, isothiazolyl,oxadiazolyl, pyridinyl, oxazolyl, isoxazolyl, piperidinyl, pyridinyl,pyrazinyl, pyridazinyl, pyrimidinyl, piperazinyl, morpholinyl,triazinyl, oxazinyl or thiazolyl, or a biheterocyclic group such asbenzazolyl, benzimidazolyl, indazolyl and benzothiazolyl. When R⁶ or R⁹is a 5- to 9-membered heterocyclic group it is preferably furyl,pyrrolyl, triazolyl, thienyl, thiadiazolyl, oxazolyl, isoxazolyl,piperidinyl, pyridinyl, pyrazinyl, benzazolyl, benzimidazolyl, indazolylor benzothiazolyl, but especially thienyl. The 5- to 12-memberedheterocyclic group can be unsubstituted or substituted, e.g. by one,two, three or four substituents selected from halo, cyano, oxo, hydroxy,carboxy, nitro, C₁-C₁₀-alkyl, C₁-C₁₀-alkylcarbonyl and C₁-C₁₀-alkoxyoptionally substituted by aminocarbonyl. However when R⁶ or R⁹ is a 5-to 12-membered heterocyclic group it is most preferably isoxazolyl,pyrazinyl, triazinyl, pyrimidinyl, pyridinyl, pyridazinyl, in particularisoxazol-3-yl, pyrazin-2-yl, [1,3,5]triazin-2-yl, pyrimidin-2-yl,pyrimidin-4-yl, pyrimidin-5-yl, pyridin-2-yl, pyridin-3-yl, pyridin-4-ylor pyridazin-3-yl.

When R⁷ is a 5- to 12-membered heterocyclic group containing at leastone ring heteroatom selected from nitrogen, oxygen and sulphur, it ispreferably a 5- to 9-membered heterocyclic group, which can be amonoheterocyclic group such as furyl, pyrrolyl, pyrrolidinyl, pyrazolyl,imidazolyl, triazolyl, tetrazolyl, thienyl, thiadiazolyl, isothiazolyl,oxadiazolyl, pyridinyl, oxazolyl, isoxazolyl, piperidinyl, pyridinyl,pyrazinyl, pyridazinyl, pyrimidinyl, piperazinyl, morpholinyl,triazinyl, oxazinyl or thiazolyl, or a biheterocyclic group such asbenzazolyl, benzimidazolyl, indazolyl and benzothiazolyl. When R⁷ is a5- to 9-membered heterocyclic group it is preferably furyl, pyrrolyl,triazolyl, thienyl, thiadiazolyl, oxazolyl, isoxazolyl, piperidinyl,pyridinyl, pyrazinyl, benzazolyl, benzimidazolyl, indazolyl orbenzothiazolyl, but especially thienyl. The 5- to 12-memberedheterocyclic group can be unsubstituted or substituted, e.g. by one,two, three or four substituents selected from halo, cyano, oxo, hydroxy,carboxy, nitro, C₁-C₁₀-alkyl, C₁-C₁₀-alkylcarbonyl and C₁-C₁₀-alkoxyoptionally substituted by aminocarbonyl.

Throughout this specification and in the claims that follow, unless thecontext requires otherwise, the word “comprise”, or variations such as“comprises” or “comprising”, will be understood to imply the inclusionof a stated integer or step or group of integers or steps but not theexclusion of any other integer or step or group of integers or steps.

Preferred compounds include those of formula I in salt or zwitterionicform wherein

L and M are (a bond and —CH₂—CH₂—) and J is C₁-C₂-alkylene,or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—)respectively and J is a bond;R¹ is a C₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur;R² is hydroxy;R³ is a C₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur,wherein R¹ and R³ are not the same;or —CR¹R²R³ together form a group of formula

where R^(a) is a bond, and R^(b) is hydroxy;R⁴ is methyl;R⁵ is C₁-alkyl substituted by —CO—NH—R⁶,or R⁵ is C₂-C₁₀-alkyl substituted by —O—R⁶ or —R⁸;R⁶ is a C₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur; andR⁸ is a C₃-C₁₅-carbocyclic group; orL and M are a bond and —CH₂—CH₂— respectively and J is C₁-C₂-alkylene,or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—)respectively and J is a bond;R¹ and R³ are both C₃-C₁₅-carbocyclic groups;R² is hydroxy;R⁴ is methyl;R⁵ is C₁-alkyl substituted by —CO—NH—R⁹; andR⁹ is a 5- to 12-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur.

Especially preferred compounds include those of formula I in salt orzwitterionic form wherein L and M are (a bond and —CH₂—CH₂—) and J isC₁-C₂-alkylene,

or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—)respectively and J is a bond;R¹ is a C₃-C₁₀-carbocyclic group, or a 5- to 9-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur;R² is hydroxy;R³ is a C₃-C₁₀-carbocyclic group, preferably phenyl or C₃-C₆-cycloalkyl,or a 5- to 9-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur,wherein R¹ and R³ are not the same;or —CR¹R²R³ together form a group of formula

where R^(a) is a bond, and R^(b) is hydroxy;R⁴ is methyl;R⁵ is C₁-alkyl substituted by —CO—NH—R⁶,or R⁵ is C₂-C₄-alkyl substituted by —O—R⁶ or —R⁸;R⁶ is a C₃-C₁₀-carbocyclic group, preferably phenyl, or a 5- to9-membered heterocyclic group having at least one ring heteroatomselected from nitrogen, oxygen and sulphur; andR⁸ is a C₃-C₁₀-carbocyclic group, preferably phenyl; orL and M are a bond and —CH₂—CH₂— respectively and J is C₁-C₂-alkylene,or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—)respectively and J is a bond;R¹ and R³ are both C₃-C₁₀-carbocyclic groups, preferably phenyl;R² is hydroxy;R⁴ is methyl;R⁵ is C₁-alkyl substituted by —CO—NH—R⁹; andR⁹ is a 5- to 9-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur, preferablyisoxazolyl, pyrazinyl or triazinyl.

The compounds of formula I are quaternary ammonium salts. Suitablecounter ions are pharmaceutically acceptable counter ions including, forexample, fluoride, chloride, bromide, iodide, nitrate, sulfate,phosphate, formate, acetate, trifluoroacetate, propionate, butyrate,lactate, citrate, tartrate, malate, maleate, succinate, benzoate,p-chlorobenzoate, diphenyl-acetate or triphenylacetate,o-hydroxybenzoate, p-hydroxybenzoate,1-hydroxynaphthalene-2-carboxylate, 3-hydroxynaphthalene-2-carboxylate,methanesulfonate and benzenesulfonate.

Compounds of formula I that contain a basic centre are capable offorming acid addition salts, particularly pharmaceutically acceptableacid addition salts. Pharmaceutically acceptable acid addition salts ofthe compound of formula I include those of inorganic acids, for example,hydrohalic acids such as hydrofluoric acid, hydrochloric acid,hydrobromic acid or hydroiodic acid, nitric acid, sulfuric acid,phosphoric acid; and organic acids, for example aliphatic monocarboxylicacids such as formic acid, acetic acid, trifluoroacetic acid, propionicacid and butyric acid, aliphatic hydroxy acids such as lactic acid,citric acid, tartaric acid or malic acid, dicarboxylic acids such asmaleic acid or succinic acid, aromatic carboxylic acids such as benzoicacid, p-chlorobenzoic acid, diphenylacetic acid or triphenylacetic acid,aromatic hydroxy acids such as o-hydroxybenzoic acid, p-hydroxybenzoicacid, 1-hydroxynaphthalene-2-carboxylic acid or3-hydroxynaphthalene-2-carboxylic acid, and sulfonic acids such asmethanesulfonic acid or benzenesulfonic acid. These salts may beprepared from compounds of formula I by known salt-forming procedures.

Compounds of formula I which contain acidic e.g. carboxyl groups, arealso capable of forming salts with bases, in particular pharmaceuticallyacceptable bases such as those well known in the art; suitable suchsalts include metal salts, particularly alkali metal or alkaline earthmetal salts such as sodium, potassium, magnesium or calcium salts, orsalts with ammonia or pharmaceutically acceptable organic amines orheterocyclic bases such as ethanolamines, benzylamines or pyridine.These salts may be prepared from compounds of formula I by knownsalt-forming procedures.

The compounds of the invention include at least one chiral centre andtherefore the compounds exist in individual optically active isomericforms or as mixtures thereof, e.g. as racemic or diastereomericmixtures. The present invention embraces both individual opticallyactive R and S isomers as well as mixtures, e.g. racemic ordiastereomeric mixtures, thereof. Particularly preferred compounds of ininvention are single isomers, either single enantiomers or singlediastereoisomers. Surprisingly these single isomers allow the mostpotent component of a mixture to be selected and surprisingly can offerimproved residency times at the M3 receptor hence delivering agents withlong duration of action which are particularly suitable for once-dailydosing.

Specific especially preferred compounds of the invention are thosedescribed hereinafter in the Examples.

Examples of specific preferred compounds of formula I in salt orzwitterionic form also include:

-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidinyl-propyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyridazin-2-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoyl-methyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoyl-methyl)-piperidinium;-   (R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidinylcarbamoyl-methyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)    piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1′-methyl-1′-(pyridazin-3-ylcarbamoyl-methyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoyl-methyl)-piperidinium;-   (R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidinylcarbamoyl-methyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-phenethyl-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoyl-methyl)-piperidinium;-   (R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;    4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;-   4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1′-(3-pyridin-2-yl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoyl-methyl)-piperidinium;-   4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoyl-methyl)-piperidinium;-   4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoymethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-phenethyl-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;-   4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-phenyl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-phenethyl-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-4-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydrox-2-phenyl-acetoxymethyl)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyrazin-2-ylcarbamoyl-methyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoyl-methyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-phenyl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-phenethyl-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-4-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyridazin-2-ylcarbamoyl-methyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyridinyl-ethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-[(S-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoyl-methyl)-pyrrolidinium;-   (R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-phenyl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-phenethyl-pyrrolidinium-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyrimidinyl-ethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyridin-4-yl-ethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoyl-methyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-pyrrolidinium;-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;    and-   (R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium.

The invention also provides a process for the preparation of compoundsof formula I which comprises:

(i) (A) reacting a compound of formula II

-   -   or a sodium salt thereof, where J, L, M, R⁴ and R⁵ are as        hereinbefore defined, with a compound of formula III

-   -   or an ester-forming derivative thereof, where R¹, R² and R³ are        as hereinbefore defined; or

(B) reacting a compound of formula IV

-   -   or a protected form thereof where R¹, R², R³, R⁴, J, L and M are        as hereinbefore defined, with a compound of formula V

X—R⁵  V

-   -   where R⁵ is as hereinbefore defined and X is chloro, bromo or        iodo; and        (ii) recovering the product in salt or zwitterionic form.

Process variant (A) may be effected using known procedures for reactinghydroxy compounds or sodium salts thereof with carboxylic acids orester-forming derivatives thereof such as acid halides or analogously ashereinafter described in the Examples. The reaction between anhydroxyl-substituted quinuclidine derivative and a carboxylic acid isconveniently carried out in an organic solvent, for exampledimethylformamide (DMF), in the presence of a coupling agent, forexample 1,1′-carbonyldiimidazole (CDI), preferably in an inertatmosphere, for example under argon. Suitable reaction temperatures arefrom 0° C. to 60° C., preferably from 30° C. to 50° C., especially about40° C.

Process variant (B) may be effected using known procedures for reactingsaturated heterocyclic amines with halogenides or analogously ashereinafter described in the Examples. The reaction is convenientlycarried out in an organic solvent, for example dimethylsulphoxide,dimethyl-formamide, ether, acetonitrile or acetone. The reaction iscarried out at a temperature between 20° C. to 120° C., convenientlybetween room temperature and 80° C.

Compounds of formula II or III are known or may be prepared by knownprocedures or analogously as hereinafter described in the Examples.

Compounds of formula IV may exist in individual optically activeisomeric forms or as mixtures thereof, e.g. as racemic or diastereomericmixtures. Preferred compounds of formula IV are compounds of formula IVaor IVb

or a protected form thereof where R¹, R², R³, R⁴, J, L and M are ashereinbefore defined.

When a compound of formula IV is a single enantiomer or is achiral,alkylation of the tertiary amine to give a compound of formula I resultsin a mixture of two diastereoisomers. These isomers may be separated byconventional techniques, e.g. by fractional crystallization or columnchromatography.

Compounds of formula IV are known or may be prepared by reacting acompound of formula VI

or a protected form thereof where R¹, R² and R³ are as hereinbeforedefined and R¹⁰ is C₁-C₄-alkyl, with a compound of formula VII

where R⁴, J, L and M are as hereinbefore defined. The reaction may beeffected using known procedures for reacting carboxylic esters withalcohols or analogously as hereinafter described in the Examples. Thereaction is conveniently carried out in an organic solvent, for examplecyclohexane or toluene, preferably in the presence of an alkali metale.g. sodium and under an inert atmosphere such as argon. The reactionmay be carried out at a temperature between 40° C. to 120° C., butpreferably under reflux conditions.

Compounds of formula IV where R² is hydroxyl may be prepared by reactinga compound of formula VIII

or a protected form thereof where R¹, R⁴, J, L and M are as hereinbeforedefined, with a compound of formula IX

XMg-R³  IX

where R³ is as hereinbefore defined and X is chloro, bromo or iodo.

Compounds of formula V or VI are known or may be prepared by knownprocedures or analogously as hereinafter described in the Examples.

Compounds of formula VII are known or may be prepared by alkylating thecorresponding secondary amine. For example compounds of formula VIIwhere R⁴ is methyl may be prepared by reacting a compound of formula X

where J, L and M are as hereinbefore defined with formaldehyde in thepresence of formic acid. The reaction is conveniently carried out in asolvent, for example water, at a temperature from 40° C. to 120° C., butpreferably about 80° C.

Compounds of formula VIII may be prepared by reacting a compound offormula VII where R⁴, J, L and M are as hereinbefore defined, with acompound of formula XI

where R¹ is as hereinbefore defined and X is chloro, bromo or iodo.

Compounds of formula IX, X or XI are known or may be prepared by knownprocedures, or analogously as hereinafter described in the Examples.

Where reference is made herein to protected functional groups or toprotecting groups, the protecting groups may be chosen in accordancewith the nature of the functional group, for example as described inProtective Groups in Organic Synthesis, T. W. Greene and P. G. M. Wuts,John Wiley & Sons Inc, Third Edition, 1999, which reference alsodescribes procedures suitable for replacement of the protecting groupsby hydrogen.

Compounds of formula I are quaternary ammonium salts and may beconverted between different salt forms using ion exchangechromatography. The compounds can be obtained in the form of hydrates'or solvates containing a solvent used for crystallization. Compounds offormula I can be recovered from reaction mixtures and purified usingknown methods. The compounds are initially isolated as diastereomericmixtures however in most cases they are preferably used inpharmaceutical compositions of the invention as single enantiomers ordiastereoisomers.

Compounds of formula I in pharmaceutically acceptable salt orzwitterionic form, hereinafter referred to alternatively as agents ofthe invention, are useful as pharmaceuticals. Accordingly the inventionalso provides a compound of formula I in pharmaceutically acceptablesalt or zwitterionic form for use as a pharmaceutical. The agents of theinvention act as muscarinic antagonists, particularly muscarinic M3receptor antagonists thereby acting as inhibitors ofbronchoconstriction.

The affinity (Ki) of agents of the invention at the human muscarinicacetylcholine M3 receptor can be determined in a competitive filtrationbinding assay with the radio-labelled antagonist [³H]n-methylscopolamine methyl chloride (NMS):

Membranes prepared from CHO cells stably are transfected with human M3receptor at 10 μg protein/well then incubated with serial dilutions ofthe agents of the invention, [³H]NMS at Kd concentration (0.25 nM) andassay buffer (20 mmol HEPES, 1 mmol MgCl₂ at pH 7.4) for 17 hours atroom temperature. The assay is carried out in a 250 μL final volume, inthe presence of a final dimethyl sulfoxide concentration of 1%. Totalbinding of [³H]NMS is determined in the absence of the agents of theinvention with a corresponding substituted volume of assay buffer.Non-specific binding of [³H]NMS is determined in the presence of 300 nMipratropium bromide. Following the incubation period, the membranes areharvested onto a Unifilter™ GF/B filter plate containing 0.05%polyethyleneimine, using a Brandel™ filtration harvester 9600. Filterplates are dried for two hours at 35° C. before the addition ofMicroscint™ ‘O’ cocktail, and are read on a Packard Topcount™scintillator using a ³H-Scintillation protocol. All ICSOs are calculatedwith the aid of XL-Fit graph package and K; values are derived using theCheng-Prusoff correction (Cheng Y., Prusoff W. H. (1973) Biochem.Pharmacol. 22 3099-3109).

The compounds of the Examples hereinbelow generally have IC₅₀ valuesbelow 1 μM in the above assay.

Having regard to their inhibition of acetyl choline binding to M3muscarinic receptors, agents of the invention are useful in thetreatment of conditions mediated by the muscarinic M3 receptor,particularly those associated with increased parasympathetic toneleading to, for example, excessive glandular secretion or smooth musclecontraction. Treatment in accordance with the invention may besymptomatic or prophylactic.

Having regard to their antimuscarinic activity, the agents of theinvention are useful in the relaxation of bronchial smooth muscle andthe relief of bronchoconstriction. Relief of bronchoconstriction can bemeasured in models such as the in vivo plethysmography models of Chonget al, J. Pharmacol. Toxicol. Methods 1998, 39, 163, Hammelmann et al,Am. J. Respir. Crit. Care Med., 1997, 156, 766 and analogous models. Theagents of the invention are therefore useful in the treatment ofobstructive or inflammatory airways diseases. In view of their longduration of action, it is possible to administer the agents of theinvention once-a-day in the treatment of such diseases. In anotheraspect, agents of the invention commonly exhibit characteristicsindicating a low incidence of side effects commonly encountered with β₂agonists such as tachycardia, tremor and restlessness, such agentsaccordingly being suitable for use in on demand (rescue) treatment aswell as prophylactic treatment of obstructive or inflammatory airwaysdiseases.

Inflammatory or obstructive airways diseases to which the presentinvention is applicable include asthma of whatever type or genesisincluding both intrinsic (non-allergic) asthma and extrinsic (allergic)asthma. Treatment of asthma is also to be understood as embracingtreatment of subjects, e.g. of less than 4 or 5 years of age, exhibitingwheezing symptoms and diagnosed or diagnosable as “wheezy infants”, anestablished patient category of major medical concern and now oftenidentified as incipient or early-phase asthmatics. (For convenience thisparticular asthmatic condition is referred to as “wheezy-infantsyndrome”.)

Prophylactic efficacy in the treatment of asthma will be evidenced byreduced frequency or severity of symptomatic attack, e.g. of acuteasthmatic or bronchoconstrictor attack, improvement in lung function orimproved airways hyperreactivity. It may further be evidenced by reducedrequirement for other, symptomatic therapy, i.e. therapy for or intendedto restrict or abort symptomatic attack when it occurs, for exampleanti-inflammatory (e.g. corticosteroid) or bronchodilatory. Prophylacticbenefit in asthma may in particular be apparent in subjects prone to“morning dipping”. “Morning dipping” is a recognised asthmatic syndrome,common to a substantial percentage of asthmatics and characterised byasthma attack, e.g. between the hours of about 4 to 6 am, i.e. at a timenormally substantially distant from any previously administeredsymptomatic asthma therapy.

Other inflammatory or obstructive airways diseases and conditions towhich the present invention is applicable include adult/acuterespiratory distress syndrome (ARDS), chronic obstructive pulmonary orairways disease (COPD or COAD), including chronic bronchitis, or dyspneaassociated therewith, emphysema, as well as exacerbation of airwayshyperreactivity consequent to other drug therapy, in particular otherinhaled drug therapy. The invention is also applicable to the treatmentof bronchitis of whatever type or genesis including, e.g., acute,arachidic, catarrhal, croupus, chronic or phthinoid bronchitis. Furtherinflammatory or obstructive airways diseases to which the presentinvention is applicable include pneumoconiosis (an inflammatory,commonly occupational, disease of the lungs, frequently accompanied byairways obstruction, whether chronic or acute, and occasioned byrepeated inhalation of dusts) of whatever type or genesis, including,for example, aluminosis, anthracosis, asbestosis, chalicosis, cysticfibrosis, ptilosis, siderosis, silicosis, tabacosis and byssinosis.

Having regard to their antimuscarinic activity, the agents of theinvention are also useful in the treatment of a condition requiringrelaxation of smooth muscle of the uterus, bladder or vascular system.They are thus useful for the prevention or alleviation of prematurelabour pains in pregnancy. They are also useful in the treatment ofchronic and acute urticaria, psoriasis, allergic conjunctivitis,actinitis, rhinitis including allergic rhinitis, mastocytosis, urinarydisorders such as urinary incontinence (particularly that caused by anoveractive bladder), pollakiuria, neurogenic or unstable bladder,cytospasm and chronic cystitis; gastrointestinal disorders such asirritable bowel syndrome, spastic colitis, diverticulitis and pepticulceration; and cardiovascular disorders such as vagally induced sinusbradycardia, as well as in ophthalmic interventions.

The agents of the invention are also useful as co-therapeutic agents foruse in combination with other drug substances such as anti-inflammatory,bronchodilatory, antihistamine, decongestant or anti-tussive drugsubstances, particularly in the treatment of obstructive or inflammatoryairways diseases such as those mentioned hereinbefore, for example aspotentiators of therapeutic activity of such drugs or as a means ofreducing required dosaging or potential side effects of such drugs. Anagent of the invention may be mixed with one or more the other drugsubstances in a fixed pharmaceutical composition or it may beadministered separately, before, simultaneously with or after the otherdrug substance(s). Accordingly the invention includes a combination ofan agent of the invention as hereinbefore described with ananti-inflammatory, bronchodilatory, antihistamine, decongestant oranti-tussive drug substance, said agent of the invention and said drugsubstance being in the same or different pharmaceutical composition.

Suitable anti-inflammatory drugs include steroids, in particularglucocorticosteroids such as budesonide, beclamethasone dipropionate,fluticasone propionate, ciclesonide or mometasone furoate, or steroidsdescribed in WO 02/88167, WO 02/12266, WO 02/100879, WO 02/00679(especially those of Examples 3, 11, 14, 17, 19, 26, 34, 37, 39, 51, 60,67, 72, 73, 90, 99 and 101), WO 03/35668, WO 03/48181, WO 03/62259, WO03/64445, WO 03/72592, WO 04/39827 and WO 04/66920; non-steroidalglucocorticoid receptor agonists, such as those described in DE10261874, WO 00/00531, WO 02/10143, WO 03/82280, WO 03/82787, WO03/86294, WO 03/104195, WO 03/101932, WO 04/05229, WO 04/18429, WO04/19935 and WO 04/26248; LTD4 antagonists such as montelukast andzafirlukast; PDE4 inhibitors such cilomilast (Ariflo® GlaxoSmithKline),Roflumilast (Byk Gulden), V-11294A (Napp), BAY19-8004 (Bayer),SCH-351591 (Schering-Plough), Arofylline (Almirall Prodesfarma),PD189659/PD168787 (Parke-Davis), AWD-12-281 (Asta Medica), CDC-801(Celgene), SelCID™ CC-10004 (Celgene), VM5541UM565 (Vernalis), T440(Tanabe), KW4490 (Kyowa Hakko Kogyo), and those disclosed in WO92/19594, WO 93/19749, WO 93/19750, WO 93/19751, WO 98/18796, WO99/16766, WO 01/13953, WO 03/39544, WO 03/104204, WO 03/104205, WO04/000814, WO 04/000839, WO 04/005258 WO 04018450, WO 04/018451, WO04/018457, WO 04/018465, WO 04/018431, WO 04/018449, WO 04/018450, WO04/018451, WO 04/018457, WO 04/018465, WO 04/019944, WO 04/019945, WO04/045607, WO 04/037805, WO 04/063197, WO 04/103998, WO 04/111044, WO05012252, WO 05012253, WO 05/013995, WO 05/030725, WO 05/030212, WO05/087744, WO 05/087745, WO 05/087749 and WO 05/090345; A_(2A) agonistssuch as those described in EP 1052264, EP 1241176, EP 409595A2, WO94/17090, WO 96/02543, WO 96/02553, WO 98/28319, WO 99/24449, WO99/24450, WO 99/24451, WO 99/38877, WO 99/41267, WO 99/67263, WO99/67264, WO 99/67265, WO 99/67266, WO 00/23457, WO 00/77018, WO00/78774, WO 01/23399, WO 01/27130, WO 01/27131, WO 01/60835, WO01/94368, WO 02/00676, WO 02/22630, WO 02/96462, and WO 03/086408, WO04/039762, WO 04/039766, WO 04/045618 and WO 04/046083; and A_(2B)antagonists such as those described in WO 02/42298.

The agents of the invention are useful in combination therapy withchemokine receptor antagonists, calcium channel blockers,alpha-adrenoceptor antagonists, dopamine agonists, endothelinantagonists, substance-P antagonists, 5-LO inhibitors, VLA-4 antagonistsand theophylline.

The agents of the invention are also particularly useful asco-therapeutic agents for use in combination with beta-2 adrenoceptoragonists. Suitable beta-2 adrenoceptor agonists include albuterol(salbutamol), metaproterenol, terbutaline, salmeterol fenoterol,procaterol, and especially, formoterol, carmoterol and pharmaceuticallyacceptable salts thereof, and compounds (in free or salt or solvateform) of formula I of WO 00/75114, which document is incorporated hereinby reference, preferably compounds of the Examples thereof, especially acompound of formula

and pharmaceutically acceptable salts thereof, as well as compounds (infree or salt or solvate form) of formula I of WO 04/16601, and alsocompounds of EP 147719, EP 1440966, EP1460064, EP 1477167, JP 05025045,WO 93/18007, WO 99/64035, US 2002/0055651, US 2004/0242622, US2004/0229904, US 2005/0133417, US 2005/5159448, WO 01/42193, WO01/83462, WO 02/66422, WO 02/70490, WO 02/76933, WO 03/24439, WO03/42160, WO 03/42164, WO 03/72539, WO 03/91204, WO 03/99764, WO04/16578, WO 04/22547, WO 04/32921, WO 04/33412, WO 04/37768, WO04/37773, WO 04/37807, WO 04/39762, WO 04/39766, WO 04/45618 WO04/46083, WO 04/80964, WO 04/087142, WO 04/089892, WO 04/108675, WO04/108676, WO 05/033121, WO 05/040103, WO 05/044787, WO 05/058867, WO05/065650, WO 05/066140 and WO 05/07908

Co-therapeutic antihistamine drug substances include cetirizinehydrochloride, acetaminophen, clemastine fumarate, promethazine,loratidine, desloratidine, diphenhydramine and fexofenadinehydrochloride.

Combinations of agents of the invention and one or more of beta-2adrenoceptor agonists, steroids, PDE4 inhibitors, A2a agonists, A2bantagonists and LTD4 antagonists may be used, for example, in thetreatment of airways diseases, including asthma and particularly COPD.Preferred triple combinations comprise an agent of the invention, abeta-2 adrenoceptor agonist and a steroid.

In accordance with the foregoing, the present invention also provides amethod for the treatment of an obstructive or inflammatory airwaysdisease which comprises administering to a subject, particularly a humansubject, in need thereof a compound of formula I, or a pharmaceuticallyacceptable salt or solvate thereof, as hereinbefore described. Inanother aspect, the invention provides a compound of formula I, or apharmaceutically acceptable salt or solvate thereof, as hereinbeforedescribed for use in the preparation of a medicament for the treatmentof an obstructive or inflammatory airways disease.

The agents of the invention may be administered by any appropriateroute, e.g. orally, for example in the form of a tablet or capsule;parenterally, for example intravenously; topically to the skin, forexample in the treatment of psoriasis; intranasally, for example in thetreatment of hay fever; or, preferably, by inhalation, particularly inthe treatment of obstructive or inflammatory airways diseases. Inparticular, the agents of the invention may be delivered as an inhalableformulation for the treatment of COPD and asthma.

In a further aspect, the invention also provides a pharmaceuticalcomposition comprising a compound of formula I in free form or in theform of a pharmaceutically acceptable salt or solvate thereof,optionally together with a pharmaceutically acceptable diluent orcarrier therefor. Such compositions may be prepared using conventionaldiluents or excipients and techniques known in the galenic art. Thusoral dosage forms may include tablets and capsules. Formulations fortopical administration may take the form of creams, ointments, gels ortransdermal delivery systems, e.g. patches. Compositions for inhalationmay comprise aerosol or other atomizable formulations or dry powderformulations.

When the composition comprises an aerosol formulation, it preferablycontains, for example, a hydro-fluoro-alkane (HFA) propellant such asHFA134a or HFA227 or a mixture of these, and may contain one or moreco-solvents known in the art such as ethanol (up to 20% by weight),and/or one or more surfactants such as oleic acid or sorbitan trioleate,and/or one or more bulking agents such as lactose. When the compositioncomprises a dry powder formulation, it preferably contains, for example,the compound of formula I having a particle diameter up to 10 microns,optionally together with a diluent or carrier, such as lactose, of thedesired particle size distribution and a compound that helps to protectagainst product performance deterioration due to moisture e.g. magnesiumstearate, typically 0.05-2.0% magnesium stearate. When the compositioncomprises a nebulised formulation, it preferably contains, for example,the compound of formula I either dissolved, or suspended, in a vehiclecontaining water, a co-solvent such as ethanol or propylene glycol and astabiliser, which may be a surfactant.

The invention also includes (A) a compound of formula I as hereinbeforedescribed in free form, or a pharmaceutically acceptable salt or solvatethereof, in inhalable form; (B) an inhalable medicament comprising sucha compound in inhalable form together with a pharmaceutically acceptablecarrier in inhalable form; (C) a pharmaceutical product comprising sucha compound in inhalable form in association with an inhalation device;and (D) an inhalation device containing such a compound in inhalableform.

Dosages of agents of the invention employed in practising the presentinvention will of course vary depending, for example, on the particularcondition to be treated, the effect desired and the mode ofadministration. In general, suitable daily dosages for administration byinhalation are of the order of 0.0001 to 30 mg/kg, typically 0.01 to 10mg per patient, while for oral administration suitable daily doses areof the order of 0.01 to 100 mg/kg.

The invention is illustrated by the following Examples.

EXAMPLES

All compounds of these examples are initially isolated as mixtures ofdiastereoisomers at the quaternary nitrogen atom. Where an individualdiastereoisomer is indicated in these examples it is isolated byfractional crystallisation of such a mixture. The stereochemistry ofthese single isomers is determined by nmr and/or xray crystallography.

Especially preferred compounds of formula I include compounds of formulaXII

where T is as shown in Table 1 below, the method of preparation beingdescribed hereinafter. All compounds are quaternary ammonium salts. Thetable also shows mass spectrometry data. The relevant counter ion isidentified in the relevant method of preparation.

TABLE 1 M/s Ex. T M+ 1

456.5 2

456.5 3

456.2 4

467.2

Further especially preferred compounds of formula I are compounds offormula XIII

where T is as shown in Table 2 below, the methods of preparation beingdescribed hereinafter. All compounds are quaternary ammonium salts. Thetable also shows mass spectrometry data. The relevant counter ion isidentified in the relevant method of preparation.

TABLE 2 M/s Ex. T M+ 5

442.4 6

442.5 7

442.2 8

453.2 9

436.5 10

438.5

Further especially preferred compounds of formula I include compounds offormula XIV

where T is as shown in Table 3 below, the methods of preparation beingdescribed hereinafter. All compounds are quaternary ammonium salts. Thetable also shows mass spectrometry data. The relevant counterion isidentified in the relevant method of preparation.

TABLE 3 M/s Ex. T M+ 11

450.4 12

450.5 13

450.1 14

461.2 15

462.2

Further especially preferred compounds of formula I include compounds offormula XV

where T is as shown in Table 4 below, the methods of preparation beingdescribed hereinafter. Both compounds are quaternary ammonium salts. Thetable also shows mass spectrometry data. The relevant counterion isidentified in the relevant method of preparation.

TABLE 4 M/s Ex. T M+ 16

462.4 17

462.4

Yet further especially preferred compounds of formula I includecompounds of formula XVI

where T is as shown in Table 5 below, the methods of preparation beingdescribed hereinafter. Both compounds are quaternary ammonium salts. Thetable also shows mass spectrometry data. The relevant counterion isidentified in the relevant method of preparation.

TABLE 5 M/s Ex. T M+ 18

448.5 19

448.4

Yet further especially preferred compounds of formula I includecompounds of formula XVII

where T is as shown in Table 6 below, the methods of preparation beingdescribed hereinafter. Both compounds are quaternary ammonium salts. Thetable also shows mass spectrometry data. The relevant counterion isidentified in the relevant method of preparation.

TABLE 6 M/s Ex. T M+ 20

448.2 21

448.4

Preparation of Intermediate Compounds

Abbreviations used are as follows: DCM is dichloromethane, DMF isdimethylformamide, and DMSO is dimethylsulfoxide, HPLC is highperformance liquid chromatography, THF is tetrahydrofuran, LC-MS isliquid chromatography mass spectrometry, CDI is1,1′-carbonyl-diimidazole.

Intermediate A 2-Bromo-N-isoxazol-3-yl-acetamide

To a stirred solution of bromoacetylbromide (5.36 ml, 61.6 mmol) indiethylether (100 ml) at −40° C. is added, dropwise over 20 minutes, asolution of 3-aminoisoxazol (5.0 ml, 67.0 mmol) and triethylamine (8.5ml, 61.4 mmol) in diethylether (20 ml). Additional diethylether (50 ml)is added and stirring continued for 3 hours. The reaction mixture isfiltered and the solution then washed with 1 M sodium carbonatesolution, 1 M hydrochloric acid and brine. Concentration followed bypurification by flash silica column chromatography (ethylacetate/iso-hexane 4:7) gives the title compound as a white solid.

Intermediate B(1R/S,2R)-2-Hydroxymethyl-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide Step B1: (R)-Pyrrolidine-1,2-dicarboxylic acid 2-tert-butylester 1-ethyl ester

(R)-Pyrrolidine-2-carboxylic acid tert-butyl ester (16.11 g, 94.1 mmol)in DCM (250 ml) under an inert atmosphere of argon is treated withtriethyl amine (26 ml, 188 mmol) and then cooled to 0° C. with a icebath. To this cooled solution is added dropwise ethyl chloroformate(8.99 ml, 94.1 mmol) and the reaction mixture is left to stir at 0° C.for 3 hours. The reaction mixture is washed with 1M HCl (2×100 ml),water, brine, dried over MgSO₄ and concentrated in vacuo to yield thetitled compound as a clear oil.

Step B2: ((R)-1-Methyl-pyrrolidin-2-yl)-methanol

A cooled (0° C.); stirred solution of lithium aluminium hydride (200 mlof a 1 M solution in THF, 207 mmol) is treated via canula, dropwise with(R)-pyrrolidine-1,2-dicarboxylic acid 2-tert-butyl ester 1-ethyl ester(22.86 g, 94.1 mmol) in THF (300 ml). After addition, the reactionmixture is left to warm to room temperature whilst stirring over night.The solution is then treated with Rochelles salt (10 g) to partiallyquench the reaction and after 30 minutes, the reaction mixture is cooled(0° C.) and water (50 ml) is added dropwise, ensuring that thetemperature does not exceed 10° C. The solvent is removed in vacuo andthe residue is taken up in chloroform: isopropyl alcohol (300 ml of a7:3 mixture) and left to stir at room temperature for 3 hours. Theresulting suspension is removed by filtration and the filtrate isconcentrated in vacuo. The resulting oil is purified by distillation onKugelrohr to yield the titled compound as a clear oil.

Step B3:(1R/S,2R)-2-Hydroxymethyl-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide

To a solution of 2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A) (3.9g, 191 mmol) in acetonitrile (95 ml) is added((R)-1-methyl-pyrrolidin-2-yl)-methanol (2.2 g, 191 mmol) inacetonitrile (5 ml). The reaction mixture is stirred at room temperaturefor 3 hours and then the solvent is removed in vacuo. The resulting oilis taken up in acetonitrile and ethyl acetate is then added. Theresulting cloudy solution is stirred at room temperature for 30 minutes.There after, the supernatant is decanted off and the solid is driedunder vacuum over two days to afford the titled compound.

Intermediate C(1R/S12R)-3-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide Step C1: (R)-3-Hydroxy-piperidine-1-carboxylic acid tert-butylester

To a cooled (0° C.) solution comprising (R)-3-hydroxy piperidinehydrochloride (5.0 g, 36.3 mmol) in water/dioxane (200 ml of a 1:1mixture) is added sodium hydrogen carbonate (10.7 g, 127 mmol) followedby di-t-butyl dicarbonate (9.11 g, 41.7 mmol), portionwise. The reactionmixture is allowed to warm to room temperature and stirred for 2 days.The resulting suspension is filtered through Celite® filter material andwashed with dioxane. The filtrate is concentrated in vacuo to removehalf the solvent and then acidified to pH 3 with 2M citric acid. Thissolution is extracted with DCM (3×100 ml) and the combined organicextracts are dried (MgSO₄) and concentrated in vacuo to yield the titledproduct as a brown oil.

Step C2: (R)-1-Methyl-piperidin-3-ol

This compound is prepared by an analogous method to((R)-1-Methyl-pyrrolidin-2-yl)-methanol (Step B2) by replacing(R)-pyrrolidine-1,2-dicarboxylic acid 2-tert-butyl ester 1-ethyl ester(Step B1) with (R)-3-Hydroxy-piperidine-1-carboxylic acid tert-butylester (Step C1).

Step C3:(1R/S,3R)-3-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide

(R)-1-Methyl-piperidin-3-ol (1.15 g, 10 mmol) and2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A) (2.25 g, 11 mmol) arestirred together in chloroform/acetonitrile (20 ml of a 1:1 mixture) atroom temperature for 1 hour. The solvent is removed in vacuo and theresulting oil is purified using C-18 reverse phase column chromatography(eluent-water:acetonitrile from 0% to 30% acetonitrile) to yield thetitled compound.

Intermediate D Cyclopentyl-H-hydroxy-thiophen-2-yl-acetic acid

To a stirred suspension of magnesium (0.232 g, 9.7 mmol) in ether (5 ml)under an atmosphere of argon is added iodine (catalytic amount). After 5minutes, the reaction mixture is treated with cyclopentyl bromide (2 ml,9.7 mmol) in ether (5 ml) portionwise over 10 minutes and is thenstirred at room temperature for 20 minutes. Meanwhile, a second reactionvessel comprising 2-thiopheneglyoxcylic acid (1 g, 6.5 mmol) in ether(10 ml) cooled to 0° C. is treated with sodium hydride (0.26 g of a 60%dispersion in mineral oil, 6.5 mmol). The reaction mixture is stirredfor 30 minutes and then the grignard reagent (prepared as describedabove) is added portion wise over 5 minutes. After stirring at roomtemperature for 4 hours, the reaction mixture is partitioned betweenwater (100 ml) and ethyl acetate (100 ml). The aqueous layer isacidified to pH 1 with 1M hydrochloric acid and then extracted withethyl acetate (50 ml). The organic portions are combined, washed withbrine, dried over magnesium sulphate and evaporated in vacuo, to yieldthe titled compound as a yellow solid.

Intermediate E Cyclohexyl-hydroxy-thiophen-2-yl-acetic acid

This compound is prepared by a method that is analogous to that used toprepare cyclopentyl-H-hydroxy-thiophen-2-yl-acetic acid (Intermediate D)by replacing cyclopentyl magnesium bromide with cyclohexyl magnesiumbromide.

Intermediate F Hydroxy-diphenyl-acetic acid 1-methyl-piperidin-4-ylester

A mixture comprising 1-methyl-piperidin-4-ol (20 g, 170 mmol) and methylbenzylate (63.1 g, 250 mmol) in cyclohexane (300 ml) is heated to 60° C.and treated with sodium (0.39 g, 17 mmol) in small portions. Thereaction mixture is then heated to 85° C. for 5 hours and then allowedto cool to room temperature overnight. The mixture is filtered and thesolid is washed with cyclohexane. The resulting crude residue is driedunder vacuum and recrystallised from hot acetonitrile to yield thetitled compound.

Intermediate G 2-Bromo-N-pyrazin-2-yl-acetamide

This compound is prepared by an analogous method to2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A) by replacing3-aminoisoxazole with 2-aminopyrazine

Intermediate H4-Hydroxy-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium bromide

This compound is prepared by an analogous method to(1R/S,3R)-3-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Intermediate C) by replacing (R)-1-methyl-piperidin-3-ol (stepC3) with 1-methyl-piperidin-4-ol and by replacing2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A) with2-bromo-N-pyrazin-2-yl-acetamide (Intermediate G).

Intermediate I4-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium bromide

This compound is prepared by an analogous method to(1R/S,3R)-3-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Intermediate C) by replacing (R)-1-methyl-piperidin-3-ol (stepC3) with 1-methyl-piperidin-4-ol.

Intermediate J 2-Bromo-N-[1,3,5]triazin-2-yl-acetamide

This compound is prepared by an analogous method to2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A) by replacing3-aminoisoxazole with [1,3,5]triazin-2-ylamine.

Intermediate K 4-Hydroxy-1-methyl-1-(3-phenyl-propyl)-piperidiniumbromide

This compound is prepared by an analogous method to(1R/S,3R)-3-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Intermediate C) by replacing (R)-1-methyl-piperidin-3-ol (stepC3) with 1-methyl-piperidin-4-ol and by replacing2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A) with 3-phenylpropylbromide.

Intermediate L 4-Hydroxy-1-methyl-1-(2-phenoxy-ethyl)-piperidiniumbromide

This compound is prepared by an analogous method to(1R/S,3R)-3-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Intermediate C) by replacing (R)-1-methyl-piperidin-3-ol (stepC3) with 1-methyl-piperidin-4-ol and by replacing2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A) with2-phenoxy-ethylbromide.

Preparation of Specific Examples Example 1(1R/S2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium bromide

To a solution comprising(1R/S,2R)-2-hydroxymethyl-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide (Intermediate B) (0.230 g, 0.718 mmol) in DMF (2 ml) is addedsodium hydride (0.057 g, of a 60% dispersion in oil, 1.44 mmol) in oneportion. The suspension is stirred at room temperature for 2 hours.Meanwhile, in a second reaction vessel, a solution ofcyclohexyl-hydroxy-phenyl-acetic acid (0.160 g, 0.68 mmol) in DMF (2 ml)is treated with CDI (0.11 g, 0.68 mmol) in one portion. The reactionmixture is stirred at room temperature for 2 hours. The resulting CDIintermediate is added to the reaction vessel containing the sodium saltof(1R/S,2R)-2-hydroxymethyl-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide and the reaction mixture is stirred at room temperature for 2.5hours. The reaction mixture is diluted with water (2 ml) and 0.13 ml ofHBr (48% solution in water) and purified using C-18 reverse phase columnchromatography (eluent-water:acetonitrile from 0% to 100% acetonitrile)to yield the titled compound.

Example 2(1R/S,3R)-3-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-piperidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium bromide (Example 1) by replacing(1R/S,2R)-2-hydroxymethyl-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-pyrrolidiniumbromide (Intermediate B) with(1R/S,2R)-3-Hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Intermediate C).

Example 34-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium bromide (Example 1) by replacing(1R/S,2R)-2-hydroxymethyl-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-pyrrolidiniumbromide (Intermediate B) with4-hydroxy-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium bromide(Intermediate I).

Example 44-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium bromide (Example 1) by replacing(1R/S,2R)-2-hydroxymethyl-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-pyrrolidiniumbromide (Intermediate B) with4-hydroxy-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium bromide(Intermediate H).

Example 5(1R/S,2R)-2-((R/S)-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide (Example 1) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclopentyl-mandelic acid.

Example 6

(1R/S,3R)-3-((R/S)-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-piperidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-3-((R/S)-(2-cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Example 2) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclopentyl-mandelic acid.

Example 74-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium bromide

This compound is prepared by an analogous method to4-(2-cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Example 3) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclopentyl-mandelic acid.

Example 84-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidiniumbromide

This compound is prepared by an analogous method to4-(2-cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidiniumbromide (Example 4) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclopentyl-mandelic acid.

Example 94-((R)-2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide (Example 1) by replacing(1R/S,2R)-2-hydroxymethyl-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-pyrrolidiniumbromide (Intermediate B) with4-Hydroxy-1-methyl-1-(3-phenyl-propyl)-piperidinium bromide(Intermediate K) and by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclopentyl-mandelic acid.

Example 104-((R)-2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-phenoxy-ethyl)-piperidiniumbromide

This compound is prepared by an analogous method to4-((R)-2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidiniumbromide (Example 9) by replacing4-Hydroxy-1-methyl-1-(3-phenyl-propyl)-piperidinium bromide(Intermediate K) with4-hydroxy-1-methyl-1-(2-phenoxy-ethyl)-piperidinium bromide(Intermediate L).

Example 11(1R/S,2R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium bromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide (Example 1) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith benzilic acid

Example 12(1R/S,3R)-3-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium bromide

This compound is prepared by an analogous method(1R/S,2R)-3-((R/S)-(2-cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide: (Example 2) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith benzilic acid.

Example 134-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide

To a stirred solution comprising hydroxy-diphenyl-acetic acid1-methyl-piperidin-4-yl ester (Intermediate F) (0.25 g, 0.77 mmol) inacetonitrile (5 ml) under an inert atmosphere of argon is added2-bromo-N-isoxazol-3-yl-acetamide (Intermediate A). The reaction mixtureis stirred overnight at room temperature and then water is added.Acetonitrile is removed in vacuo and the resulting mixture is decantedinto a clean flask and left overnight. The solid that formed is filteredto yield the titled product.

Example 144-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidiniumbromide

This compound is prepared by an analogous method to4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide (Example 13) by replacing 2-bromo-N-isoxazol-3-yl-acetamide(Intermediate A) with 2-bromo-N-pyrazin-2-yl-acetamide (Intermediate G).

Example 154-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-([1,3,5]-triazin-2-ylcarbamoylmethyl)-piperidiniumbromide

A solution comprising hydroxy-diphenyl-acetic acid1-methyl-piperidin-4-yl ester (Intermediate F) (0.3 g, 0.9 mmol) and2-bromo-N-[1,3,5]triazin-2-yl-acetamide (Intermediate J) (0.2 g, 0.9mmol) in acetonitrile/chloroform (2 ml of a 1:1 mixture) is stirredunder an inert atmosphere of argon at room temperature for 2 days. Thetitled product is observed by LC-MS. (M+462.2)

Example 16(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-thiophen-2-yl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide (Example 1) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclohexyl-hydroxy-thiophen-2-yl-acetic acid (Intermediate E).

Example 17(1R/S,3R)-3-((R/S)-(2-Cyclohexyl-2-hydroxy-2-thiophen-1-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide

This compound is prepared by an analogous method(1R/S,2R)-3-((R/S)-(2-cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide: (Example 2) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclohexyl-hydroxy-thiophen-2-yl-acetic acid (Intermediate E).

Example 181R/S,2R)-2-((R/S)-(2-Cyclopentyl-2-hydroxy-2-thiophen-2-yl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide (Example 1) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclopentyl-H-hydroxy-thiophen-2-yl-acetic acid (Intermediate E).

Example 19(1R/S,3R)-3-((R/S)-(2-Cyclopentyl-2-hydroxy-1-thiophen-2-yl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide

This compound is prepared by an analogous method(1R/S,2R)-3-((R/S)-(2-cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide: (Example 2) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith cyclopentyl-H-hydroxy-thiophen-2-yl-acetic acid (Intermediate E).

Example 20 (1R/S,2R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium

This compound is prepared by an analogous method to(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide (Example 1) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith 9-hydroxy-9-fluorene carboxylic acid.

Example 21 (1R/S,3R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium

This compound is prepared by an analogous method(1R/S,2R)-3-((R/S)-(2-cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide: (Example 2) by replacing cyclohexyl-hydroxy-phenyl-acetic acidwith 9-hydroxy-9-fluorene carboxylic acid.

1. A compound of formula I

in salt or zwitterionic form wherein L and M are (a bond and —CH₂—CH₂—),(—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—) respectively and J isC₁-C₂-alkylene, or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and—CH₂—) respectively and J is a bond; R¹ is a C₃-C₁₅-carbocyclic group ora 5- to 12-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur; R² is hydrogen,hydroxy, or C₁-C₄-alkyl optionally substituted by hydroxy; R³ is aC₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclic grouphaving at least one ring heteroatom selected from nitrogen, oxygen andsulphur, wherein R¹ and R³ are not the same; or —CR¹R²R³ together form agroup of formula

where R^(a) is a bond, —O—, —S—, —CH₂—, —CH═CH—, —CH₂—CH₂—, amino or—N(CH₃)—, and R^(b) is hydrogen, hydroxy, or C₁-C₄-alkyl optionallysubstituted by hydroxy; R⁴ is C₁-C₄-alkyl; R⁵ is C₁-alkyl substituted by—SO—R⁶, —S(═O)₂—R⁶, —CO—R, —CO—O—R, —CO—NH—R⁶ or —R⁷, or R⁵ isC₂-C₁₀-alkyl substituted by —O—R⁶, —S—R⁶, —SO—R⁶, —S(═O)₂—R⁵, —CO—R⁶,—O—CO—R⁶, —CO—O—R⁶, —NH—CO—R, —CO—NH—R⁶, —R⁷ or —R⁸, or R⁵ isC₂-C₁₀-alkenyl or C₂-C₁₀-alkynyl optionally substituted by —R⁷ or —R⁸;R⁶ is a C₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur, or R⁶ is C₁-C₁₀-alkyl optionally substituted byC₁-C₁₀-alkoxy, —O—R⁷, a C₃-C₁₅-carbocyclic group or a 5- to 12-memberedheterocyclic group having at least one ring heteroatom selected fromnitrogen, oxygen and sulphur; R⁷ is a 5- to 12-membered heterocyclicgroup having at least one ring heteroatom selected from nitrogen, oxygenand sulphur; and R⁸ is a C₃-C₁₅-carbocyclic group; or L and M are (abond and —CH₂—CH₂—), (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—)respectively and J is C₁-C₂-alkylene, or L and M are (—CH₂— and—CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—) respectively and J is a bond; R¹ andR³ are each independently a C₃-C₁₅-carbocyclic group or a 5- to12-membered heterocyclic group having at least one ring heteroatomselected from nitrogen, oxygen and sulphur; R² is hydrogen, hydroxy, orC₁-C₄-alkyl optionally substituted by hydroxy; R⁴ is C₁-C₄-alkyl; R⁵ isC₁-alkyl substituted by —CO—R⁹, —CO—O—R⁹ or —CO—NH—R⁹, or R⁵ isC₂-C₁₀-alkyl substituted by R⁹, —CO—R⁹, —CO—O—R⁹, —NH—CO—R⁹ or—CO—NH—R⁹, and R⁹ is a 5- to 12-membered heterocyclic group having atleast one ring heteroatom selected from nitrogen, oxygen and sulphur. 2.A compound according to claim 1, wherein L and M are (a bond and—CH₂—CH₂—) and J is C₁-C₂-alkylene, or L and M are (—CH₂— and —CH₂—CH₂—)or (—CH₂—CH₂— and —CH₂—) respectively and J is a bond; R¹ is aC₃-C₁₅-carbocyclic group or a 5- to 12-membered heterocyclic grouphaving at least one ring heteroatom selected from nitrogen, oxygen andsulphur; R² is hydroxy; R³ is a C₃-C₁₅-carbocyclic group or a 5- to12-membered heterocyclic group having at least one ring heteroatomselected from nitrogen, oxygen and sulphur, wherein R¹ and R³ are notthe same; or —CR¹R²R³ together form a group of formula

where R^(a) is a bond, and R^(b) is hydroxy; R⁴ is methyl; R⁵ isC₁-alkyl substituted by —CO—NH—R⁶, or R⁵ is C₂-C₁₀-alkyl substituted by—O—R⁶ or —R⁸; R⁶ is a C₃-C₁₅-carbocyclic group or a 5- to 12-memberedheterocyclic group having at least one ring heteroatom selected fromnitrogen, oxygen and sulphur; and R⁸ is a C₃-C₁₅-carbocyclic group; or Land M are a bond and —CH₂—CH₂— respectively and J is C₁-C₂-alkylene, orL and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—) respectivelyand J is a bond; R¹ and R³ are both C₃-C₁₅-carbocyclic groups; R² ishydroxy; R⁴ is methyl; R⁵ is C₁-alkyl substituted by —CO—NH—R⁹; and R⁹is a 5- to 12-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur.
 3. A compoundaccording to claim 2, wherein L and M are (a bond and —CH₂—CH₂—) and Jis C₁-C₂-alkylene, or L and M are (—CH₂— and —CH₂—CH₂—) or (—CH₂—CH₂—and —CH₂—) respectively and J is a bond; R¹ is a C₃-C₁₀-carbocyclicgroup, or a 5- to 9-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur; R² is hydroxy; R³is a C₃-C₁₀-carbocyclic group, preferably phenyl or C₃-C₆-cycloalkyl, ora 5- to 9-membered heterocyclic group having at least one ringheteroatom selected from nitrogen, oxygen and sulphur, wherein R¹ and R³are not the same; or —CR¹R²R³ together form a group of formula

where R^(a) is a bond, and R^(b) is hydroxy; R⁴ is methyl; R⁵ isC₁-alkyl substituted by —CO—NH—R⁶, or R⁵ is C₂-C₄-alkyl substituted byO—R⁶ or —R⁸; R⁶ is a C₃-C₁₀-carbocyclic group, preferably phenyl, or a5- to 9-membered heterocyclic group having at least one ring heteroatomselected from nitrogen, oxygen and sulphur; and R⁸ is aC₃-C₁₀-carbocyclic group, preferably phenyl; or L and M are a bond and—CH₂—CH₂-respectively and J is C₁-C₂-alkylene, or L and M are (—CH₂— and—CH₂—CH₂—) or (—CH₂—CH₂— and —CH₂—) respectively and J is a bond; R¹ andR³ are both C₃-C₁₀-carbocyclic groups, preferably phenyl; R² is hydroxy;R⁴ is methyl; R⁵ is C₁-alkyl substituted by —CO—NH—R⁹; and R⁹ is a 5- to9-membered heterocyclic group having at least one ring heteroatomselected from nitrogen, oxygen and sulphur, preferably isoxazolyl,pyrazinyl or triazinyl.
 4. A compound according to claim 1 that isselected from the group consisting of:(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium bromide;(1R/S,3R)-3-((R/S)-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-piperidiniumbromide;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidiniumbromide;(1R/S,2R)-2-((R/S)-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide;(1R/S,3R)-3-((R/S)-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoyl-methyl)-1-methyl-piperidiniumbromide;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidiniumbromide;4-((R)-2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidiniumbromide;4-((R)-2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-phenoxy-ethyl)-piperidiniumbromide;(1R/S,2R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide;(1R/S,3R)-3-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidiniumbromide;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidiniumbromide;(1R/S,2R)-2-((R/S)-(2-Cyclohexyl-2-hydroxy-2-thiophen-2-yl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide; (1R/S,3R)-3-((R/S)-(2-Cyclohexyl-2-hydroxy-2-thiophen-2-yl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide;(1R/S,2R)-2-((R/S)-(2-Cyclopentyl-2-hydroxy-2-thiophen-2-yl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidiniumbromide;(1R/S,3R)-3-((R/S)-(2-Cyclopentyl-2-hydroxy-2-thiophen-2-yl-acetoxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidiniumbromide; (1R/S,2R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium;and (1R/S,3R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium.5. A compound according to claim 1 that is selected from the groupconsisting of:(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-(2-pyrazin-2-yl-ethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-(2-pyrimidin-4-yl-ethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-(2-pyrimidin-2-yl-ethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-(2-pyrimidin-5-yl-ethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxzol-3-yl-ethyl)-1-methyl-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-yl-ylcarbamoyl)-methyl]-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoyl-methyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoyl-methyl)-piperidinium;(R)-3-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoyl-methyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-phenethyl-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;(R)-3-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;4-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoylmethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;4-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-phenethyl-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;4-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-phenyl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrazin-2-yl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-2-yl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-4-yl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(3-pyridin-3-yl-propyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(3-isoxazol-3-yl-propyl)-1-methyl-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-phenethyl-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-2-yl-ethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-4-yl-ethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(2-pyridin-3-yl-ethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-piperidinium;4-(9-Hydroxy-9H-fluorene-9-carbonyloxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-piperidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-phenyl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-phenethyl-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-4-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Cyclohexyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-phenyl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-phenethyl-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-4-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-(2-isoxazol-2-yl-ethyl)-1-methyl-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyrazin-2-ylcarbamoyl-methyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Cyclopentyl-2-hydroxy-2-phenyl-acetoxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-4-yl-ethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(2-Hydroxy-2,2-diphenyl-acetoxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-phenyl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrazin-2-yl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrimidin-4-yl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrimidin-2-yl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyrimidin-5-yl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyridin-2-yl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyridin-4-yl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(3-pyridin-3-yl-propyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(3-isoxazol-3-yl-propyl)-1-methyl-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-phenethyl-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyrazin-2-yl-ethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyrimidin-4-yl-ethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyrimidin-2-yl-ethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyrimidin-5-yl-ethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyridin-2-yl-ethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyridin-4-yl-ethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(2-pyridin-3-yl-ethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(2-isoxazol-3-yl-ethyl)-1-methyl-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-[(5-methyl-isoxazol-3-ylcarbamoyl)-methyl]-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(pyrazin-2-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(pyridazin-3-ylcarbamoyl-methyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-([1,3,5]triazin-2-ylcarbamoylmethyl)-pyrrolidinium;(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-methyl-1-(pyrimidin-4-ylcarbamoylmethyl)-pyrrolidinium;and(R)-2-(9-Hydroxy-9H-fluorene-9-carbonyloxymethyl)-1-(isoxazol-3-ylcarbamoylmethyl)-1-methyl-pyrrolidinium.6. A compound according to claim 1 in combination with at least one drugsubstance which is an anti-inflammatory, a bronchodilator, anantihistamine, a decongestant or an anti-tussive drug substance. 7.(canceled)
 8. A pharmaceutical composition comprising as activeingredient a compound according claim
 1. 9-11. (canceled)
 12. A processfor the preparation of a compound of formula I as claimed in claim 1which comprises: (i) (A) reacting a compound of formula II

or a sodium salt thereof, where J, L, M, R⁴ and R⁵ are as defined inclaim 1, with a compound of formula III

or an ester-forming derivative thereof, where R¹, R² and R³ are asdefined in claim 1; or (B) reacting a compound of formula IV

or a protected form thereof where R¹, R², R³, R⁴, J, L and M are asdefined in claim 1, with a compound of formula VX—R⁵  V where R⁵ is as defined in claim 1 and X is chloro, bromo oriodo; and (ii) recovering the product in salt or zwitterionic form. 13.A method of treating a condition mediated by the muscarinic M3 receptorwith a compound according to claim
 1. 14. A method of treating aninflammatory or allergic condition with a compound according to claim 1.15. A compound according to claim 1, wherein said compound is a singleenantiomer.